Ask Suicide-Screening Questions (ASQ) Toolkit*
Fact Sheet
Brief Description
The National Institute of Mental Health developed the Ask Suicide-Screening Questions (ASQ) Toolkit to screen
and assess individuals experiencing suicidal ideation. The toolkit includes the ASQ screener and the Brief Suicide
Safety Assessment (BSSA).
Target Population
The ASQ toolkit can be administered to all individuals between the ages of 8-24 who report suicidal thoughts or
feelings of depression, sadness, or hopelessness.
Administration Details
The ASQ toolkit can be administered by any practitioner, clinical or nonclinical, in any setting, including
emergency departments, inpatient medical/surgical units, and outpatient primary care/speciality care practices.
To maintain continuity of care and rapport with the client, the ASQ should be administered by the practitioner
who initially learned about the suicidal ideation. If they need to administer a BSSA, the practitioner should
partner with a trained clinician (i.e. a social worker, nurse practitioner, physician assistant, physician, or other
mental health clinician) to determine whether the client requires a more in-depth mental health evaluation once
the entire toolkit is administered.
The first step is to administer the ASQ screener to determine if a client has any thoughts or feelings at all about
committing suicide. The ASQ comprises five questions that take less than two minutes to administer. If a client
answers no to the first four questions, the screen is complete, the remaining question does not need to be asked,
and no further assessment is needed. It is important to note that if a client answers yes to the fifth question on
the screen, “Are you having thoughts of killing yourself right now?” they are considered to have an acute positive
screen and are at imminent risk of committing suicide. They should not be left alone and must be given a full
mental health evaluation.
If a client answers yes to any of the first four questions, then you must administer the BSSA. The BSSA takes
approximately 10 minutes to administer and involves these steps:
● Praising the client for their honesty on the ASQ
● Assessing the client’s frequency of suicidal thoughts, suicide plan, past behavior, symptoms, and social
support and stressors
● Interviewing the client with their parent/guardian (ask for permission if the client is 18 years or older)
● Making a safety plan with the client
● Determining disposition
● Providing resources
Scoring
Neither the ASQ nor the BSSA provide a numerical score. A positive screen on the ASQ is indicated by an answer
of yes to any of the first four questions or to the fifth question. You will complete BSSA scoring in the
determining disposition section after interviewing the client. The dispositions available include:
● Emergency psychiatric evaluation.
● Further evaluation of risk is necessary.
● Patient may benefit from nonurgent mental health follow-up.
Fact Sheet
Brief Description
The National Institute of Mental Health developed the Ask Suicide-Screening Questions (ASQ) Toolkit to screen
and assess individuals experiencing suicidal ideation. The toolkit includes the ASQ screener and the Brief Suicide
Safety Assessment (BSSA).
Target Population
The ASQ toolkit can be administered to all individuals between the ages of 8-24 who report suicidal thoughts or
feelings of depression, sadness, or hopelessness.
Administration Details
The ASQ toolkit can be administered by any practitioner, clinical or nonclinical, in any setting, including
emergency departments, inpatient medical/surgical units, and outpatient primary care/speciality care practices.
To maintain continuity of care and rapport with the client, the ASQ should be administered by the practitioner
who initially learned about the suicidal ideation. If they need to administer a BSSA, the practitioner should
partner with a trained clinician (i.e. a social worker, nurse practitioner, physician assistant, physician, or other
mental health clinician) to determine whether the client requires a more in-depth mental health evaluation once
the entire toolkit is administered.
The first step is to administer the ASQ screener to determine if a client has any thoughts or feelings at all about
committing suicide. The ASQ comprises five questions that take less than two minutes to administer. If a client
answers no to the first four questions, the screen is complete, the remaining question does not need to be asked,
and no further assessment is needed. It is important to note that if a client answers yes to the fifth question on
the screen, “Are you having thoughts of killing yourself right now?” they are considered to have an acute positive
screen and are at imminent risk of committing suicide. They should not be left alone and must be given a full
mental health evaluation.
If a client answers yes to any of the first four questions, then you must administer the BSSA. The BSSA takes
approximately 10 minutes to administer and involves these steps:
● Praising the client for their honesty on the ASQ
● Assessing the client’s frequency of suicidal thoughts, suicide plan, past behavior, symptoms, and social
support and stressors
● Interviewing the client with their parent/guardian (ask for permission if the client is 18 years or older)
● Making a safety plan with the client
● Determining disposition
● Providing resources
Scoring
Neither the ASQ nor the BSSA provide a numerical score. A positive screen on the ASQ is indicated by an answer
of yes to any of the first four questions or to the fifth question. You will complete BSSA scoring in the
determining disposition section after interviewing the client. The dispositions available include:
● Emergency psychiatric evaluation.
● Further evaluation of risk is necessary.
● Patient may benefit from nonurgent mental health follow-up.
